the midwife`s journal < contents

37. homebirth far from home
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oisin7When someone phones me to talk about the possibility of homebirth I try to quickly assess how they reached this point. Homebirth is not well understood in this part of the world. Anyone seeking information may have been told "it's not legal", or "how could you think about doing something so risky?" or "don't think about what you want, do what is best for the baby."

The other day a man phoned, and after the usual conversation he said "I'm totally convinced about homebirth, but my partner isn't. She thinks she'll need the drugs." Sadly, I don't expect to hear from them again. The man can't give birth, no matter how convinced and committed he is. Women have to hear the arguments, and make their own decisions. I find myself saying over and over again "Wherever you are, and no matter who is caring for you, they can't even take your pulse without your permission." I don't want to see women submitting to my control any more than the domination of an authoritarian medical system.

A few months ago a man contacted by e-mail me from the UK. He and his pregnant wife and their toddler were moving to Melbourne. She would be needing a midwife to attend her for birth at home. This experience has given me new insight into the expectations of different women as they plan their birthings.

The woman's plan seemed to be based on choice - she simply preferred to be in her own home. Her first child had been born at home, with midwifery care under the National Health Scheme. Her labour and birth had not been particularly easy; she had relied heavily on the gas that the midwife carried for pain relief, and her midwife had spoken of needing to transfer to hospital when she had difficulties with the third stage, but she still wanted to birth her second baby at home.

This woman was a stranger in a foreign land. Although we speak the same language we speak it differently. Although many of our ancestors come from the 'old country' our culture is quite different. I think I understand, as I recall our move to Michigan in 1973, in the latter half of my pregnancy with my first child. Being away from home, and from everything that is familiar, is difficult for all sorts of reasons.

Preparations for birth included practical matters - gathering a bundle of old sheets and towels is not usually a problem, but when you have just stepped off a plane with a couple of suit cases, such items are not part of the household stock. The woman also set about contacting the local Nursing Mothers' group, and a play group for her little boy. This was important in settling in to her new home. There were people in the neighbourhood who could be counted on to help with her little boy, and who would care about this family.

It must have really seemed like the end of the world when we suddenly experienced a couple of weeks without gas, which we depend on for cooking, heating, and hot water. Mercifully the weather was warm, and food could be cooked on a bar-b-q or in a microwave oven. But hot water is not easily substituted for. Hot water, the most valuable pain reliever in homebirth, and we had none. The woman waited patiently until the gas supply had been restored before her labour began.

Her attitude toward birth at home was different from that of any other woman I have attended. There was none of the resolute strength that comes from having to convince oneself that the decision is a reasonable one, despite the objection of family, friends and most health professionals. I think she would have been quite frightened and overwhelmed by the thought of going to hospital. There is an enormous culture change from homebirth in England to hospital birth in Melbourne. This quiet, gentle young woman chose to avoid that experience.

The baby was born in the bathroom. The mother held him to her body and we made a comfortable warm place for her to sit, with her back resting against the side of the bath. My colleague and I watched quietly as the new parents admired their beautiful child. As he sought his mother's breast she shivered slightly, and expelled the placenta.

The birth completed, the woman began to tell us how this birth had differed from the first. The quiet, unhurried third stage, without the injection of oxytocic was, she told us, the way she had wanted to be cared for last time. I think a lot of memories which had been suppressed flooded back and she was able to speak of them as she rested quietly.

Once in bed there were photos to be taken and long distance phone calls to be made. The digital camera made images that were sent electronically to England and Scotland that night!

As far as the clinical records are concerned this birth was quite straight-forward. All the recordings of physical observations are normal - the time taken for the stages of labour, and the condition of the mother and baby. But to me there were exceptional features. The woman's deep, innocent trust in herself, and her acceptance of me to go into that place with her reminded me of how privileged I am. And I think the memories the woman has from this birth will affirm for her that her choice was a good one.

photo used with permission

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